Bansal, A S, Bradley, A S, Bishop, K N et al. · Brain, behavior, and immunity · 2012 · DOI
This review examines whether immune system problems and viral infections play a role in ME/CFS. Researchers found modest signs of increased inflammation and cytokines (immune signaling molecules) in some patients, along with weakened natural killer cells that normally fight infections. While patients don't have more herpes virus exposure than healthy people, some evidence suggests their bodies struggle to fully control and clear these viruses, which could explain why symptoms persist.
Understanding the immune and viral mechanisms in ME/CFS could guide development of targeted therapies more effective than current approaches. This review highlights that viral persistence and immune dysfunction may be interconnected, offering a biological rationale for investigating antivirals, immunomodulatory treatments, and T cell memory restoration.
This review does not establish causation—whether immune abnormalities cause ME/CFS or result from it remains unclear. It also does not prove that viral persistence is the primary driver in all patients, as ME/CFS is heterogeneous and some cases follow stress rather than infection. The evidence presented is suggestive rather than definitive, reflecting ongoing scientific uncertainty.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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